"The survey asks whether the UK should follow Israel's lead and say
that those who are on the organ donor register should get priority if they
subsequently need a transplant. "It always seemed to me that fairness is quite a
fundamental British value but we have never put that in the context of organ
donation," Johnson said.

"The NHSBT survey asks about extending the recently introduced practice by
which the Driver and Vehicle Licensing Centre "nudges" those renewing or
updating licences into deciding whether they want to join the donor register to
other documents, such as marriage applications or wills. Johnson floated using
the new universal credit, the single payment for those seeking work or on low
incomes."

The article also speaks of the shortage of deceased donor organs:
"About 1,000 people die in the UK each year because they do not get a
transplant, according to NHSBT. Johnson said more people wanted to become donors
but the transplant service could not use all the organs they donated. More than
500,000 people die in Britain each year, but only about 3,000 in circumstances
where they could realistically become organ donors.
"The reality is you have to die in hospital, on a ventilator, also in the
intensive care or emergency department. The number of people dying who are under
the age of 75, which is where most of our donors come from, has dropped by about
15% in the last few years. The people who are dying therefore tend to be older,
they tend to have more co-morbidity than the rest of the population and, like
the rest of the population, they have a tendency to be fatter. Consequently
there are a number of people who would like us to use their organs but their
organs might not be suitable."

**************

Before we get too excited, note that it's a lot easier to consider changes than to enact them: see my 2008 post on attempts in Britain to move towards presumed consent for organ donation.

"The first 54 chains facilitated 272 transplantations between February 14, 2008 and June 29, 2011...."These first 272 transplants were completed in 40 months and were part of 54 chains that averaged 5.0 transplants long...."In the NKR experience many bridge donors remained motivated and donated months after their intended recipients’ transplantation. One bridge donor even donated more than 1-year afterwards...."The longest chain involved 21 recipients and 21 donors...."There were seven broken chains due to bridge donors becoming unavailable. Unlike traditional paired donation where the consequences of a donor ‘backing-out’ are devastating, in chain transplantation, the next recipient does not suffer ‘irreparable harm’ as they have not lost their willing incompatible donor and can participate in a new exchange when the transplants are carried out sequentially."

Sunday, July 29, 2012

Need some background as you drop to one knee? There's a market for that...Shock and Aww!

"She had no idea what this was all leading to until Mr. Centner, who had carefully orchestrated this flash mob, took her hand and led her into the circle of dancers.
...
"When asked why some men make a spectacle of their marriage proposal, W. Bradford Wilcox, the director of the National Marriage Project at the University of Virginia, said: “Over-the-top proposals allow men to signal to a future wife, and to family and friends, that they are all in. They are ready to man up, forgo all others and become a responsible husband.”
...
"Which helps explain why, when it comes to proposing, “they want the wow factor,” said Paula Broussard, founder of Dance Mob Nation, a production company based in Los Angeles that has made a specialty out of staging engagements, like the one for Mr. Centner, and other events. Having the aid of a middleman, so to speak, lowers the pressure of having to create a unique will-you-marry-me moment, she said. “They can still have something beautiful, romantic and fun,” she said, “and they don’t personally have to get up and dance — unless they want to.”

"A flash proposal can start at $2,000 for a simple affair, which involves all supporting players — choreographers, videographers, rehearsal rental space and D.J.’s, but Ms. Broussard said that the costs could vary widely because each event is customized. If the would-be groom wants multiple cameras, professional dancers with complex choreography and costumes, the costs can surpass $10,000."

" Five-year-old Didier Drogba was moving to France to live with an uncle, a professional footballer.
...
"Last Saturday Drogba, now aged 34, was a match-winner as Chelsea won its first ever Champions League. The Ivorian scored Chelsea’s equalising goal, then netted the decisive penalty. “Drogba’s final”, as it will surely be remembered, proved his last match of eight seasons with Chelsea. He says he is leaving London, and Shanghai Shenhua hopes to sign him. Since that flight from Abidjan, Drogba’s career has become a case study in how a modern professional (footballer or otherwise) should manage mobility.

It gives a quick history of kidney exchange developments, leading up to my recent work on random graphs with Itai Ashlagi, David Gamarnik (who was in the audience) and Mike Rees (who was probably doing a transplant while I spoke). And it ends with some discussion of repugnance--motivated by the laws against buying and selling organs for transplant.

Microsoft has come a long way towards mastering the art of presenting the video and the slides at the same time...you can't see where I'm pointing with the laser pointer or with my hand (since that goes off camera), and when I backtrack on the slides you can seldom see it in the video, but the slides are presented in a way that's mostly well synchronized with the talk (until near the end), and the cameraman doesn't have to choose between the slides and the speaker. (I don't think you can hear the questions though, I'm wearing a microphone, but there wasn't one for the audience members.) (I wrote the above paragraph after viewing on a large screen: when I viewed the same video on my laptop, and then again on an iPad I had a very different, much less satisfactory experience, and couldn't see the slides at all...:(

Thursday, July 26, 2012

"Many people needing kidney transplants have a willing donor, but they can’t
take the kidney because it’s not compatible with their blood type or immune
system. Paired exchanges, where incompatible donor/recipient pairs swap kidneys
with another incompatible pair, is one trick for getting kidneys into
hard-to-match patients. Another trick is a donor chain: A person gives a kidney
to a clearinghouse or kidney exchange, which can set off a chain of donations.

"Within the kidney transplant community, there’s been an ongoing debate over
whether long chains ultimately mean more transplants. “The mathematical question
was, are we really transplanting more people?” says Alvin Roth, an expert in
game theory and market design at Harvard. “The answer is yes, a lot more.”
...
"It turns out to not be an easy problem. It’s very hard computationally,” says
MIT’s Itai Ashlagi, who conducted the analysis along with Roth, MIT’s David
Gamarnik, and Michael Rees, a transplant surgeon at the University of Toledo and
medical director of the Alliance for Paired Donation, which arranged the first
non-simultaneous chain of 10 kidney transplants."

The story also quotes a dissenting voice from Dorry Segev at Johns Hopkins...
**********

The resolution urges the government to draw up a bill allowing the circumcision of boys.

Germany's main political parties - together with Jewish and Muslim groups - have criticised the ruling by the Cologne court in June.

Chancellor Angela Merkel said it risked making Germany a "laughing stock".

The Cologne ruling involved a doctor who carried out a circumcision on a four-year-old that led to medical complications.

The doctor involved in the case was acquitted and the ruling was not binding. However, critics feared it could set a precedent for other German courts.

Germany's Medical Association told doctors after the ruling not to perform circumcisions.

'Tolerant country'
The motion approved on Thursday in the lower house of parliament says the government should "present a draft law in the autumn... that guarantees that the circumcision of boys, carried out with medical expertise and without unnecessary pain, is permitted".

"Jewish and Muslim religious life must continue to be possible in Germany. Circumcision has a central religious significance for Jews and Muslims," it added.

The new law would overrule the decision by the Cologne court.

Ahead of the vote, Foreign Minister Guido Westerwelle said the proposed motion showed that Germany was a "tolerant and cosmopolitan country".

European Jewish and Muslim groups earlier also joined forces to defend circumcision.

An unusual joint statement was signed by leaders of groups including the Rabbinical Centre of Europe, the European Jewish Parliament, the European Jewish Association, Germany's Turkish-Islamic Union for Religious Affairs and the Islamic Centre Brussels.

"We consider this to be an affront [to] our basic religious and human rights," it said.

The BBC's Stephen Evans in Berlin says opinion in Germany about the issue has been mixed, though slightly more Germans were in favour of the ban.

He says that many readers' comments on newspaper websites have indicated anger that this generation of Germans seems to be being constricted in its actions because of the Holocaust."

"Angela Merkel's spokesman has promised Germany's Jewish and Muslim communities they will be free to carry out circumcision on young boys, despite a court ban that has raised concerns about religious freedom.

"The government said it would find a way around a ban imposed by a court in Cologne in June as a matter of urgency.

"For everyone in the government it is absolutely clear that we want to have Jewish and Muslim religious life in Germany," said Merkel's spokesman, Steffen Seibert.
*********

"German lawmakers have passed a cross-party motion to protect religious circumcision, after a regional court ruled it amounted to bodily harm.

The resolution urges the government to draw up a bill allowing the circumcision of boys.

Germany's main political parties - together with Jewish and Muslim groups - have criticised the ruling by the Cologne court in June.

Chancellor Angela Merkel said it risked making Germany a "laughing stock".

The Cologne ruling involved a doctor who carried out a circumcision on a four-year-old that led to medical complications.

The doctor involved in the case was acquitted and the ruling was not binding. However, critics feared it could set a precedent for other German courts.

Germany's Medical Association told doctors after the ruling not to perform circumcisions.

...

The motion approved on Thursday in the lower house of parliament says the government should "present a draft law in the autumn... that guarantees that the circumcision of boys, carried out with medical expertise and without unnecessary pain, is permitted".

"Jewish and Muslim religious life must continue to be possible in Germany. Circumcision has a central religious significance for Jews and Muslims," it added.

The new law would overrule the decision by the Cologne court.

Ahead of the vote, Foreign Minister Guido Westerwelle said the proposed motion showed that Germany was a "tolerant and cosmopolitan country".

...

The BBC's Stephen Evans in Berlin says opinion in Germany about the issue has been mixed, though slightly more Germans were in favour of the ban.

He says that many readers' comments on newspaper websites have indicated anger that this generation of Germans seems to be being constricted in its actions because of the Holocaust.

ABSTRACT
We study the design of mechanisms satisfying two desiderata— incentive compatibility and privacy. The first, requires that each agent should be incentivized to report her private information truthfully. The second, privacy, requires the mechanism not reveal ‘much’ about any agent’s type to other agents. We propose a notion of privacy we call Joint Differential Privacy. It is a variant of Differential Privacy, a robust notion of privacy used in the Theoretical Computer Science literature. We show by construction that such mechanisms, i.e. ones which are both incentive compatible and jointly differentially private exist when the game is ‘large’, i.e. there are a large number of players, and any player’s action affects any other’s payoff by at most a small amount. Our mechanism adds carefully selected noise to no-regret algorithms similar to those studied in Foster-Vohra [FV97] and Hart-Mas-Colell [HMC00]. It therefore implements an approximate correlated equilibrium of the full information game induced by players’ reports.
*********

As I understand it, adding appropriate randomness to regret learning
algorithms doesn’t harm their long term equilibration properties, and gives
them good privacy properties, which together give them good incentive
properties.

"President Obama today named 96 researchers as recipients of the Presidential Early Career Awards for Scientists and Engineers, the highest honor bestowed by the United States Government on science and engineering professionals in the early stages of their independent research careers."

Ruthanne Hanto reported on the progress of the Organ Procurement and Transplantation Network (OPTN) Kidney Paired Donation (KPD) Pilot Program run by UNOS.
"The pilot has made about 240 matches since its first run on Oct. 27, 2010, but about 220 of the offers were declined, and only 19 of the matches led to transplantation."

The pilot program hopes to add bridge donors--donors who temporarily end a chain and donate later--at some future time.

In the meantime, the story covers an ongoing debate about whether having multiple kidney exchange networks is a good thing. There's general agreement that, run well, a larger network creates a thicker market which would produce more transplants. And the support of the OPTN, which deals with the nation's deceased donors, gives the pilot program enormous convening power, since they already have working relations with every transplant center in the country.

Nevertheless, the other programs have been vastly more successful in producing transplants, both for patients in general and for the most highly sensitized patients who now make up the majority of those in kidney exchange networks. (It's hard to come by exact numbers, but we're talking two orders of magnitude--the pilot program so far accounts for about 1% of the kidney exchange transplants to date.) So the story quotes both Ruthanne Hanto and Stanford surgeon Marc Melcher as saying that, for the moment, it would be premature to try to close any of the successful networks down, not least because they are where the innovation is taking place.
(Melcher: “I
think at some point most people agree that we need to have a national program. I
think really the question is when, and when have we really learned enough about
the right way to go.")

The story also quotes Hopkins surgeon Dorry Segev who reaches the opposite conclusion, and would apparently be glad to close down the independent networks: "There's a tremendous amount of competition among the various KPD providers in
this country, and this competition is actually hurting the chances for those
hardest-to-match patients.” *******************

My recent papers which have some bearing on this controversy, in the sense that they are about best practices pioneered in practice by other exchange networks (namely nonsimultaneous chains), are these:

"One in seven said they had felt forced to cope with clinical problems beyond their competence or experience, according to a survey carried out by the General Medical Council, with a small proportion saying this happened on “a daily basis”.

Saturday, July 21, 2012

In 2009, Lewis and Rotjan surveyed the entire hermit crab population on Carrie Bow Cay. Many crabs were living in shells that were a tight fit or had one too many holes. As they grow, hermit crabs must move into larger shells, so they are always on the lookout for a more spacious dwelling. And an undamaged shell is preferable to a broken one, even if the shells are the same size. Knowing this, the researchers decided to dramatically change the available hermit crab real estate on Carrie Bow Cay. They placed 20 beautifully intact shells that were a little too big for most hermit crabs at various spots around the island and watched what happened.

When a lone crab encountered one of the beautiful new shells, it immediately inspected the shelter with its legs and antennae and scooted out of its current home to try on the new shelter for size. If the new shell was a good fit, the crab claimed it. Classic hermit crab behavior. But if the new shell was too big, the crab did not scuttle away disappointed—instead, it stood by its discovery for anywhere between 15 minutes and 8 hours, waiting. This was unusual. Eventually other crabs showed up, each one trying on the shell. If the shell was also too big for the newcomers, they hung around too, sometimes forming groups as large as 20. The crabs did not gather in a random arrangement, however. Rather, they clamped onto one another in a conga line stretching from the largest to smallest animal—a behavior the biologists dubbed "piggybacking."

Only one thing could break up the chain of crabs: a Goldilocks hermit crab for whom the shell introduced by Lewis and Rotjan was just right. As soon as such a crab claimed its new home, all the crabs in queue swiftly exchanged shells in sequence. The largest crab at the front of the line seized the Goldilocks crab's abandoned shell. The second largest crab stole into the first's old shell. And so on.

No one had ever documented such well-orchestrated shell swapping before, but similar behavior was not unknown. In 1986, Ivan Chase of Stony Brook University made the first observations of hermit crabs exchanging shells in a "vacancy chain"—a term originally coined by social scientists to describe the ways that people trade coveted resources like apartments and jobs. When one person leaves, another moves in. Since then, several researchers—including Lewis and Rotjan—have studied the behavior in different hermit crab species. Some preliminary evidence suggests that other animals use vacancy chains too, including clown fish, lobsters, octopuses and some birds. As Chase explains in the June issue of Scientific American, vacancy chains are an excellent way to distribute resources: Unlike more typical competition, a single vacancy chain benefits everyone involved—each individual gets an upgrade. So it makes sense that hermit crabs and other animals have evolved sophisticated social behaviors to make the most of vacancy chains.

The orderly vacancy chain that Lewis and Rotjan observed is called a synchronous vacancy chain, which is different from an asynchronous vacancy chain in which a lone crab encounters a shell, claims it and leaves behind its old home, which is later seized by a different crab that never interacts with the first animal. As the above video makes clear, however, synchronous vacancy chains are not always civilized affairs. Sometimes crabs fight each other for the best shell or gather in violent groups. And the exchanges often happen extremely quickly. Lewis and Rotjan had to slow down the footage just to see what was happening and it is still difficult to make out: three hermit crabs crowd a large green shell; the largest claims the green shell and the other two swiftly trade up. Lewis thinks the chain would have been more orderly if the crabs were not disturbed by two biologists filming them.

Friday, July 20, 2012

"What is the best way to use the kidney of an altruistic donor so that the greatest number of patients get transplants?

"To answer this question, we gathered data from a kidney exchange clearinghouse. Included was detailed information about patients’ blood and tissue types, which told us how hard it would be to find matches for them. We analyzed the data using the tool of graph theory, an approach used in mathematics and computer science to understand relationships among pairs of objects. This tool is used to find the largest number of matches achievable in each exchange program. Working with us were two pioneers of kidney exchange, Michael Rees, a transplant surgeon at the University of Toledo, and Alvin Roth, an economics professor at Harvard Business School.

"We found that long chains and long cycles of donations are essential to helping the greatest number of patients. This is especially true for patients whose blood or tissue types make them difficult to match. The percentage of hard to match patients in kidney exchange programs is very high since easy to match patients can often find a donor without the aid of the exchange program (even when enrolling the program they can be matched quickly while hard to match patients accumulate over time). But lengthy chains will benefit hard to match patients while not harming easy to match patients who are in kidney exchange programs, we found."

Stanford Law School has issued a memo to the legal community, dated July 17, 2012 (reporting on a June 29 letter to the Judicial Conference), saying that they will now freely communicate, before the dates allowed under the plan, with judges who do not stick to the hiring plan. The reason? Every other law school is doing it, and so it makes sense to do it openly...Here are my papers on that market...

Monday, July 16, 2012

One of the ways the internet is changing job markets has to do with making it easier to transmit job market materials. (This becomes even more important as the internet makes it easier for job candidates to apply to a larger number of jobs.) Competing services have sprung up to serve this need, and as the market matures we are starting to see some consolidation.

"Job seekers will be able to apply for positions directly from advertisements in
the JIL by creating a free Interfolio account
...
"All departments that place ads in the 2012–13 JILwill be able to use
Interfolio’s suite of online search-management tools, called ByCommittee.
ByCommittee provides a single secure Web interface for departments to manage
search-committee memberships for multiple searches and to receive candidate
applications, dossiers, and other materials."
...
"Letter writers receive requests for letters directly from a candidate’s
Interfolio account and submit their letters to Interfolio’s centralized dossier
service."
********

In Economics, some preliminary discussions have taken place about the possibility of a similar kind of integration between the job listing service Job Openings for Economists (JOE) and the application-materials aggregator Econjobmarket.org. but it remains for at least another year to see whether these discussions will be fruitful.
********
Previous related posts:Academic letters of reference;

"Innovation comes from myriad sources, including the bastions of East Coast learning, but Stanford has established itself as the intellectual nexus of the information economy.
...

If the Ivy League was the breeding ground for the élites of the American Century, Stanford is the farm system for Silicon Valley. When looking for engineers, Schmidt said, Google starts at Stanford. Five per cent of Google employees are Stanford graduates. The president of Stanford, John L. Hennessy, is a director of Google; he is also a director of Cisco Systems and a successful former entrepreneur. Stanford’s Office of Technology Licensing has licensed eight thousand campus-inspired inventions, and has generated $1.3 billion in royalties for the university. Stanford’s public-relations arm proclaims that five thousand companies “trace their origins to Stanford ideas or to Stanford faculty and students.” They include Hewlett-Packard, Yahoo, Cisco Systems, Sun Microsystems, eBay, Netflix, Electronic Arts, Intuit, Fairchild Semiconductor, Agilent Technologies, Silicon Graphics, LinkedIn, and E*Trade.
...

"But Stanford’s entrepreneurial culture has also turned it into a place where many faculty and students have a gold-rush mentality and where the distinction between faculty and student may blur as, together, they seek both invention and fortune. Corporate and government funding may warp research priorities. A quarter of all undergraduates and more than fifty per cent of graduate students are engineering majors. At Harvard, the figures are four and ten per cent; at Yale, they’re five and eight per cent. Some ask whether Stanford has struck the right balance between commerce and learning, between the acquisition of skills to make it and intellectual discovery for its own sake."

Saturday, July 14, 2012

"In the first criminal organ-trafficking case in the U.S., Quick took the witness stand at the sentencing of Levy Izhak Rosenbaum, a Brooklyn, New York, man who pleaded guilty to brokering black-market sales of human kidneys to three Americans. After hearing Quick’s account of how Rosenbaum paid him $25,000 for a kidney, U.S. District Judge Anne Thompson sentenced Rosenbaum to 2 1/2 years in prison.

“It’s a kind of trading in human misery,” Thompson said of the black-market kidney trade. Rosenbaum “charged a fee” for kidneys while using “a complicated web of transactions” to finance his trade, she said. “He corrupted himself.”

See earlier posts on this case here, and yesterday's story about a conviction in Japan here.

Friday, July 13, 2012

"Presiding Judge Shoji Ogawa said the two defendants had damaged public trust in the organ transplant system, noting Horiuchi procured a kidney solely through financial means..."The 1997 Organ Transplantation Law bans all trade in organs, while the ethical guidelines of the Japan Society for Transplantation only permit live organ donation between family members to prevent illegal harvesting.The Japan Organ Transplant Network is the only entity permitted to act as an intermediary for organ transplants.

"The law also forbids anyone from either requesting or promising payment for organs and from receiving commissions for mediating illegal transplants, to ensure a level playing field for potential recipients and to encourage voluntary donations from healthy citizens.

"The doctor allegedly tried to sidestep the law by technically adopting the donor "

Thursday, July 12, 2012

Ricky Vohra has an interesting post called $’s and Kidneys in which he notices that surgeons may have a financial interest in opposing a monetary market for kidneys, and provides some interesting background links.

The following paper discusses the roles and relationships of the Department of Health and Human Services, the Organ Procurement and Transplant Network (OPTN), the Organ Procurement Organizations (OPOs) and the United Network for Organ Sharing (UNOS), as determined by the National Organ Transplant Act of 1984 and its subsequent interpretations. Its focus is the debate over the different waiting times to receive a deceased donor organ in different regions of the country, resulting from the regional (as opposed to national) allocation of organs, based on how many deceased donors are in each region (and not on how many patients):

And here's a news story about Tampa General Hospital's active transplant programs. It details some of the revenues:

"The revenues a transplant program can generate are also significant. For example, the average estimated hospital admission fee nationwide for a heart transplant patient in 2011 was $634,300, according to the United Network of Organ Sharing. The nonprofit network helps the federal government manage the nation’s organ transplant system.
The average hospital admission fee for a single lung transplant in 2011 was $302,900, the network estimates. Other average estimates from the network: A liver transplant was $316,900; a pancreas was $108,900; and a kidney transplant was $91,200."

See also Diving deep into SchoolChoiceby Robert Reichardt
"The new choice process consolidated over 60 different processes into one. Acomputer programwas used to assign students to schools based on student preferences, number of available seats, andschool preferences(e.g. siblings, residents, or auditions for Denver School of the Arts).A second round is open now through August 31, 2012 for students who are not happy with their current assignment or did not enter the first round.

"The choice process worked. DPS was able to collect over 20,000 hand-written choice requests and implement a complex computer program to assign students to schools.

"There are huge differences in demand for schools. The differences are largest in high schools: Denver School of Science and Technology, Stapleton, had 8.2 first choice requests per available seat compared to Denver Online High School which had .01 first choice requests per seat. This is a difference of 82,000%."

Tuesday, July 10, 2012

"As Elisa Gordon notes, the collection of stories represent the experiences of liver and kidney donors; donors whose organ was successfully and unsuccessfully transplanted into a recipient; related and unrelated donors; and donors who had overwhelmingly positive experiences, mixed experiences, and negative experiences. In these stories we read about a wide variety of motives for donation and concerns with the donation experience. We hope that the collection of personal narratives and commentaries by Drs. Dianne LaPointe Rudow and Paul Root Wolpe will lead to a better understanding of the current living donation process as well as improvements in that process for future donors."